VIDEO: Is the stethoscope dying? High-tech options pose threat

World-renowned cardiologist believes the device is just a pair of ‘rubber tubes’

A page from a 1869 catalog of instruments and medical supplies with diagrams of various models of stethoscopes. (National Library of Medicine via AP)

A page from a 1869 catalog of instruments and medical supplies with diagrams of various models of stethoscopes. (National Library of Medicine via AP)

Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.

It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, as well as artificial intelligence and smartphone apps that help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.

Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”

It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”

In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic: Stethoscope skills are still taught, and proficiency is required for doctors to get their licences.

Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.

Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.

At many medical schools, it’s the newer devices that really get students’ hearts pumping.

Those at the Indiana University’s medical school, one of the nation’s largest, learn stethoscope skills, but also get training in hand-held ultrasound in a program launched last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.

The devices advance “our ability to take peek under the skin into the body,” he said, though he added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead.

He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”

READ MORE: B.C. researcher gets $1.08 million to study the link between sugar, immune cells and cancer

Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.

Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.

When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under $200, compared with at least a few thousand dollars for some of the high-tech devices.

But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.

With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”

ALSO READ: Ottawa spending $24.5M to research health benefits, risks of pot use

Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” he said.

“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.”

The Associated Press

Like us on Facebook and follow us on Twitter

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

The District of Stewart has adopted a strategic plan for 2020/21 with six focus areas. (District of Stewart/Facebook)
Stewart adopts 2020 strategic plan

Economy, community areas of focus

Kendra Willems, seen here Nov. 5, created a Facebook page to help facilitate social supports such as clothing donations in an informal manner that supplements existing supports and charities. (Jake Wray/Terrace Standard)
Skeena Voices | ‘We could all use that kind of goodness’

Kendra Willems, new to Terrace, founds charitable Facebook page

Firefighters work to cool a semi truck engine that caught fire at the corner of Eby St. and Hwy 16 around 12:30 p.m. on Nov. 26
Semi truck engine catches fire in Terrace

Hwy 16 briefly closed between Sande Overpass and Eby St.

Skeena MLA Ellis Ross at his swearing in on Thursday (Nov. 26), with his wife, Tracey, left, mother, Frieda, and grandson, Parker. (Ellis Ross photo)
Ellis Ross sworn in as Skeena MLA

Ceremonies happening virtually rather than all in-person in Victoria

A woman wears a protective face covering to help prevent the spread of COVID-19 as she walks along the seawall in North Vancouver Wednesday, November 25, 2020.THE CANADIAN PRESS/Jonathan Hayward
911 new COVID-19 cases, 11 deaths as B.C. sees deadliest week since pandemic began

Hospitalizations reach more than 300 across the province

Black Press Media and BraveFace have come together to support children facing life-threatening conditions. Net proceeds from these washable, reusable, three-layer masks go to Make-A-Wish Foundation BC & Yukon.
Put on a BraveFace: Help make children’s wishes come true

Black Press Media, BraveFace host mask fundraiser for Make-A-Wish Foundation

More than 60 cm of snow has fallen at Ulkatcho First Nation near Anahim Lake in the Chilcotin since a snowfall warning went into effect Thursday, Nov. 26. (Graham West photo)
VIDEO: More than 60 cm of snowfall in Chilcotin since Thursday, Nov. 26

Graham West of Ulkatcho First Nation captures the scene on video

Screenshot of Pastor James Butler giving a sermon at Free Grace Baptist Church in Chilliwack on Nov. 22, 2020. The church has decided to continue in-person services despite a public health order banning worship services that was issued on Nov. 19, 2020. (YouTube)
2 Lower Mainland churches continue in-person services despite public health orders

Pastors say faith groups are unfairly targeted and that charter rights protect their decisions

A big job: Former forests minister Doug Donaldson stands before a 500-year-old Douglas fir in Saanich to announce preservation of some of B.C.’s oldest trees, July 2019. (B.C. government)
B.C. returning to ‘stand-alone’ forests, rural development ministry

Horgan says Gordon Campbell’s super-ministry doesn’t work

Alexandre Bissonnette, who pleaded guilty to a mass shooting at a Quebec City mosque, arrives at the courthouse in Quebec City on February 21, 2017. THE CANADIAN PRESS/Mathieu Belanger - POOL
Court strikes down consecutive life sentences; mosque shooter has prison term cut

The decision was appealed by both the defence and the Crown

Gold medallists in the ice dance, free dance figure skating Tessa Virtue and Scott Moir, of Canada, pose during their medals ceremony at the 2018 Winter Olympics in Pyeongchang, South Korea, Tuesday, Feb. 20, 2018. THE CANADIAN PRESS/AP-Charlie Riedel
Olympic champions Virtue, Moir and Tewksbury among 114 Order of Canada inductees

Moir and Virtue catapulted to national stardom with their gold-medal performances at the Winter Olympics in 2018

Shoppers line up in front of a shop on Montreal’s Saint-Catherine Street in search of Black Friday deals in Montreal, Friday, Nov. 27, 2020. THE CANADIAN PRESS/Paul Chiasson
Black Friday shopping in a pandemic: COVID-19 closes some stores, sales move online

Eric Morris, head of retail at Google Canada, says e-commerce in Canada has doubled during the pandemic.

School District 27 announced the first confirmed case of COVID-19 this week (Nov. 23) at Lake City Secondary School Williams Lake campus. (Angie Mindus photo - Williams Lake Tribune)
Entire gym class at northern B.C. high school isolating after confirmed COVID case

Contact tracing by Interior Health led to the quarantine

Most Read